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Front end duties
H.I.T
| Question | Answer |
|---|---|
| when collecting basic info, who do you go to? | go to the patient and family |
| when you get the basic info what do you compare it to? | to what is in the medical record or financial record |
| what do you if the info doesn't match? | flags can show up to indicate a possible problem. Then further verification can be requested, |
| whats the 1st step to verify the pt's health ins? | the staff member asks to see the pt's health ins card to compare it to the info on file |
| Why does the staff member call the ins comp? | to double-check that the ins info is valid, before starting the conversation it is essential to write down the name of the person who is providing this info |
| birthday rule | applies to dependent kids whose parents have more than 1 ins policy. the parent whose bday comes 1st in the calendar yr. is designated as the primary plan |
| third-party liability ins | if an accident has occurred the 3rd party liability ins should be filed as primary |
| medicare vs medicaid | for pts enrolled in both medicare & Medicaid, medicare always pays for services 1st. Medicaid is referred as the payer of last resort |
| state children health ins program | this program is jointly funded by the fed/gov & the states |
| what are the 2 kinds of commercial ins? | private & employer- based self ins |
| private health ins plans | these plans are paid for through premiums, which are a pre-established amt set by ins comp & paid regularly |
| employers-based self ins | comps save $ by self insuring their employee health plans rather than buying coverage from private ins comps, costs are lower |
| blue cross & blue shield plans | these plans were the 1st prepaid plans in the U.S. Originally blue cross covered hospital care & blue shield covered physician services, They merged to form blue cross & blue shield association (BC/BS) in 1982 |
| what are 2 major categories? | HMOs & PPOs |
Created by:
diasiar
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